Dialysis Access

Dialysis Access

Hemodialysis is a procedure by which toxins are removed from the bloodstream in patients with kidney failure. “Dialysis access” refers to the means by which hemodialysis is performed and either involves the use of a hemodialysis catheter (IV tube) placed in a vein in the neck or a surgically placed arteriovenous (AV) fistula or graft in the arm. A properly functioning dialysis access is crucial to allow you to undergo your lifesaving dialysis treatments and prevent the buildup of toxins and fluids in your body.

As the only comprehensive outpatient vascular venter in Northern Colorado, we at APEX Endovascular are uniquely equipped to handle all of your dialysis access needs in the safety and convenience of our state-of-the-art facility without the hassle and risk of checking into the hospital.



At APEX Endovascular, we recognize that if you have kidney failure, your dialysis access is truly your “lifeline”. Dr. Ahmed has been performing minimally invasive dialysis access procedures at numerous hospitals on the Front Range for over 7 years. Seeing the need for a safer, more convenient and cost-effective option for our dialysis patients, we are excited to offer the first state-of-the-art outpatient dialysis access option in Northern Colorado.

The professionals at APEX Endovascular will work closely with your kidney doctor, surgeon, and dialysis center staff to help keep your dialysis access functioning properly so you can spend less time worrying and more time enjoying the things you love.

Services we offer:

Dialysis Fistula Mapping

Dialysis fistulas and grafts are surgically placed communications between the arteries and veins in the arm. Your surgeon may request vascular “mapping” as part of the surgical planning. At APEX, we use ultrasound and/or venography (contrast injection under xray) to determine the size and layout of the vessels in our safe and convenient outpatient center.

Hemodialysis Catheter Placement

Hemodialysis catheters are specially designed tubes that are placed in the vein at the base of your neck similar to an IV in your arm. These catheters can then be used to perform hemodialysis, usually on a temporary basis while you are undergoing placement of a surgical fistula or graft. Often times, these catheters are placed in the hospital setting which is inconvenient for the patient and increases the risk of infection. At APEX, we can place dialysis catheters in our safe outpatient facility allowing you to avoid the hassle and risk of a hospital based procedure. The procedure takes about 15 minutes and is performed with minimal “twilight” sedation. 

Evaluation and Maintenance of Dialysis Fistulas and Grafts

Surgically placed dialysis fistulas and grafts are the most durable and effective long-term option for obtaining hemodialysis. Unfortunately, these accesses require regular maintenance to keep them functioning properly. If you have been receiving dialysis for some time now, you’ve probably undergone a procedure to open your fistula or graft, likely in the hospital setting. In fact, most dialysis patients will require more than one minimally invasive procedure each year.

At APEX Endovascular, our highly trained staff are experts at evaluating and treating fistula and graft problems. Evaluation begins with a physical exam and possibly an ultrasound of your access to look for signs of an underling problem.

If needed, we may proceed to a minimally invasive procedure called a venogram or “fistulogram” in which the doctor starts a small IV in your arm and injects contrast dye to actually look at the flow of blood in the fistula or graft and surrounding arteries and veins.

Often times, the venogram will reveal areas of narrowing in the veins and arteries which is the most common recurrent problem with fistulas and grafts. These can usually be easily treated with a small balloon designed to open the vessel (balloon angioplasty) or on occasion, may require placement of a stent to hold the vessel open. 

Sometimes clot will form in the fistula or graft causing complete blockage. This requires urgent attention to restore blood flow. At APEX, we use state of the art, minimally invasive techniques to remove the clot through a tiny poke in the skin without the need for open surgery or hospitalization.

The procedures usually take less than an hour and are performed with minimal “twilight” sedation.

Proper maintenance of your dialysis access requires close monitoring by a team of professionals and often times requires you to undergo minimally invasive procedures on a yearly, or more frequent, basis. Until now, this has meant dealing with the inconvenience of a hospital check-in and increased risk of illness and infection due to exposure to other sick patients. At APEX endovascular, we will handle all of your dialysis access needs in a safe and convenient out-patient setting so you can get back to focusing on the thing that you love.

Your safety is our #1 priority

Hospitals are for Sick People!

With resurgence of dangerous COVID variants and other drug resistant bugs, we at APEX Endovascular feel strongly that routine procedures should not be performed in hospitals where the risk of exposure and illness is very high.

At APEX Endovascular, we are focused on individual service and maintain the highest infection control measures to ensure your safety.

• All of our staff are immunized

• We only treat one patient at a time

Don’t Take Chanced With Your Health!